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1.
Environ Pollut ; 292(Pt A): 118362, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34648836

RESUMO

The fetus is prenatally exposed to a mixture of organochlorine pesticides (OCPs), mercury (Hg), docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and selenium (Se) through maternal seafood consumption in real-life scenario. Prenatal exposure to these contaminants and nutrients has been suggested to affect thyroid hormone (TH) status in newborns, but the potential relationships between them are unclear and the joint effects of the mixture are seldom analyzed. The aim of the study is to investigate the associations of prenatal exposure to a mixture of OCPs, Hg, DHA, EPA and Se with TH parameters in newborns. 228 mother-infant pairs in Shanghai, China were included. We measured 20 OCPs, total Hg, DHA, EPA and Se in cord blood samples as exposure variables. The total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels and the FT3/FT4 ratio in cord serum were determined as outcomes. Using linear regression models, generalized additive models and Bayesian kernel machine regression, we found dose-response relationships of the mixture component with outcomes: among the contaminants, p,p'-DDE was the most important positive predictor of TT3, while HCB was predominantly positively associated with FT3 and the FT3/FT4 ratio, indicating different mechanisms underlying these relationships; among the nutrients, EPA was first found to be positively related to the FT3/FT4 ratio. Additionally, we found suggestive evidence of interactions between p,p'-DDE and HCB on both TT3 and FT3, and EPA by HCB interactions for TT3, FT3 and FT3/FT4 ratio. However, the overall effects of the mixture on thyroid hormone parameters were not significant. Our result suggests that prenatal exposure to p,p'-DDE, HCB and EPA as part of a mixture might affect thyroid function of newborns in independent and interactive ways. The potential biological mechanisms merit further investigation.


Assuntos
Mercúrio , Praguicidas , Teorema de Bayes , China , Feminino , Sangue Fetal , Humanos , Recém-Nascido , Nutrientes , Gravidez , Hormônios Tireóideos , Tireotropina , Tiroxina
2.
Spectrochim Acta A Mol Biomol Spectrosc ; 264: 120261, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34419830

RESUMO

Bovine serum albumin (BSA) has been used as a transporter protein for levothyroxine (LT4) and rutin, due to its property of binding to various ligands. Rutin binding to the BSA-LT4 complex can bring many benefits due to its proven pharmacological properties. Using Fourier-Transform Infrared Spectroscopy (FT-IR) the changes induced by rutin in the structure of BSA-LT4 complex were determined. Fluorescence studies allowed us to determine the quenching mechanism and affinity of rutin to the BSA-LT4 complex. The thermodynamic parameters suggest the binding of rutin to BSA-LT4 is a spontaneous process, driven by enthalpy and electrostatic forces. Also, the second derivative of the emission spectra suggests the Trp's of BSA are located in two different microenvironments. Thermal and chemical denaturation of BSA-LT4-rutin complex presents similar behavior but with better stability of the complex in case of chemical denaturation. Molecular docking studies show the binding of the two ligands to the same BSA site, suggesting that rutin may influence the bond of LT4 with the protein. Studies on the antioxidant activity of the BSA-LT4-rutin complex suggest that the presence of LT4 decreases the antioxidant activity of the rutin, but even so this antioxidant activity can be used to bring benefits for medical purposes.


Assuntos
Rutina , Soroalbumina Bovina , Sítios de Ligação , Simulação de Acoplamento Molecular , Ligação Proteica , Soroalbumina Bovina/metabolismo , Espectrometria de Fluorescência , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier , Termodinâmica , Tiroxina
3.
Acta Clin Croat ; 60(2): 246-253, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34744274

RESUMO

Isolated maternal hypothyroxinemia (IMH) is defined as the presence of low maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating hormone (TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR) (p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion (p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis, TSH was a significant variable predicting Apgar score (ßst=0.05597, p=0.047), body mass index predicting birth weight (ßst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR (ßst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (ßst=-0.004778, p=0.003) and premature delivery (ßst=0.028112, p=0.004) in NTF group. The impact of IMH in pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes.


Assuntos
Cesárea , Complicações na Gravidez , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , República da Macedônia do Norte/epidemiologia , Tiroxina
4.
Neurol India ; 69(5): 1389-1390, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747819

RESUMO

Rise in intracranial tension (ICT) has varied clinical presentation which can range from subtle disturbances like headache to frank neurologic impairment. An important aspect is rapidity of rise of ICT. Pseudotumor cerebri is associated with many syndromes, toxication, and drugs. Our case is a unique one given the rarity of eltroxin, which is otherwise relatively safe drug and commonly used in this part of the world, induced Pseudotumor cerebri. Our patient had dramatic response to discontinuation of levothyroxine.


Assuntos
Pseudotumor Cerebral , Tiroxina , Cefaleia , Humanos , Pseudotumor Cerebral/induzido quimicamente , Síndrome
5.
Medicine (Baltimore) ; 100(41): e27490, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731129

RESUMO

BACKGROUND: Prunella vulgaris (PV), a traditional Chinese medical herb, is considered beneficial for some thyroid diseases. However, the effectiveness is not consistent in different studies. This review compiles the evidence from randomized controlled trials (RCTs) and quantifies the effects of PV preparation on thyroid nodules. METHODS: Eight databases were searched up to April 2021 to identify eligible studies. Only RCTs were included. Meta-analysis of homogeneous studies was performed by RevMan5.3 software. Cochrane risk of bias assessment tool version 2.0 was used to assess the risk of bias of each trial. The research screening, data extraction, and risk of bias assessment were employed by 2 reviewers independently, and disagreement will be decided by a third senior reviewer. The risk ratio (RR), mean difference (MD) and corresponding 95% confidence interval (CI) of each study are summarized. RESULTS: Thirteen RCTs with 1468 patients were included in this study. A meta-analysis showed that the RR of the clinical efficacy of PV combined with levothyroxine sodium tablets was 1.22 (95% CI [1.11, 1.33]). The MD of thyroid nodule diameter was -0.43 (95% CI [-0.63, -0.22]). The MD of free triiodothyronine and free tetraiodothyronine levels was -1.99 (95% CI [-3.14, -0.86]) and -3.20 (95% CI [-5.50, -0.89]), respectively. The RR of the adverse reaction rate was 0.67 (95% CI [0.36, 1.22]), and the RR of the clinical efficacy of PV preparation combined with thyroxin tablets was 1.29 (95% CI [1.03, 1.62]). CONCLUSIONS: PV combined with levothyroxine sodium tablets or thyroxin tablets has more benefits for thyroid nodules, further improving the clinical efficiency, reducing the diameter of nodules and reducing the occurrence of adverse reactions. However, the quality of these studies is uncertain, and higher quality and more RCTs are needed to provide comprehensive evidence-based medical evidence in the future.


Assuntos
Lamiaceae/efeitos adversos , Prunella/efeitos adversos , Nódulo da Glândula Tireoide/tratamento farmacológico , Estudos de Casos e Controles , Composição de Medicamentos/métodos , Quimioterapia Combinada , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Humanos , Iodeto Peroxidase/sangue , Lamiaceae/química , Masculino , Medicina Tradicional Chinesa/métodos , Prunella/química , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Nódulo da Glândula Tireoide/patologia , Tiroxina/administração & dosagem , Tiroxina/uso terapêutico , Resultado do Tratamento , Tri-Iodotironina/sangue
6.
J Pak Med Assoc ; 71(11): 2672-2673, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783759

RESUMO

Thyroid disorders can be difficult to manage, especially in childhood and adolescence. Sudden fluctuations may occur in thyroid function, due to a variety of physiological, pathological, pharmacological and psychosocial reasons. This communication describes the etiology and management of such conditions. We term these fluctuations as thyroid tantrums, and define them as sudden disruptions in thyroid function, in persons on treatment for hypothyroidism. Thyroid tantrums may be recognized clinically or on the basis of laboratory findings. A pragmatic approach to management, focusing on therapy assessment, testing technique, targeting biomedical illness and training, is suggested in this article.


Assuntos
Hipotireoidismo , Doenças da Glândula Tireoide , Adolescente , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/tratamento farmacológico , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia , Tiroxina/uso terapêutico
7.
BMC Gastroenterol ; 21(1): 431, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34794374

RESUMO

PURPOSE: The aim of the study is to explore the independent association of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance. METHODS: A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)], hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China. RESULTS: Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4 ± 44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1-3, respectively, p = 0.007) and fatty liver index (FLI) score (47.7 (33.9-60.8), 61.5 (45.1-88.9) and 90.5 (84.5-94.8), respectively, p < 0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (ß (95%CI): 0.024 (0.004-0.043), p = 0.020), HOMA-IR (ß (95%CI): 0.091 (0.007-0.174), p = 0.034), CAP (ß (95%CI): 25.45 (2.59-48.31), p = 0.030) and FLI (ß (95%CI): 0.121 (0.049-0.194), p = 0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis. CONCLUSIONS: Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults. Trial registration Registration is not applicable for our study.


Assuntos
Fígado Gorduroso , Resistência à Insulina , Adulto , China , Estudos Transversais , Humanos , Obesidade/complicações , Sobrepeso/complicações , Glândula Tireoide , Hormônios Tireóideos , Tireotropina , Tiroxina , Tri-Iodotironina
8.
Trials ; 22(1): 852, 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34838132

RESUMO

BACKGROUND: Brain death frequently induces hemodynamic instability and cardiac stunning. Impairments in cardiac performance are major contributors to hearts from otherwise eligible organ donors not being transplanted. Deficiencies in pituitary hormones (including thyroid-stimulating hormone) may contribute to hemodynamic instability, and replacement of thyroid hormone has been proposed as a means of improving stability and increasing hearts available for transplantation. Intravenous thyroxine is commonly used in donor management. However, small controlled trials have not been able to demonstrate efficacy. METHODS: This multicenter study will involve organ procurement organizations (OPOs) across the country. A total of 800 heart-eligible brain-dead organ donors who require vasopressor support will be randomly assigned to intravenous thyroxine for at least 12 h or saline placebo. The primary study hypotheses are that thyroxine treatment will result in a higher proportion of hearts transplanted and that these hearts will have non-inferior function to hearts not treated with thyroxine. Additional outcome measures are the time to achieve hemodynamic stability (weaning off vasopressors) and improvement in cardiac ejection fraction on echocardiography. DISCUSSION: This will be the largest randomized controlled study to evaluate the efficacy of thyroid hormone treatment in organ donor management. By collaborating across multiple OPOs, it will be able to enroll an adequate number of donors and be powered to definitively answer the critical question of whether intravenous thyroxine treatment increases hearts transplanted and/or provides hemodynamic benefits for donor management. TRIAL REGISTRATION: ClinicalTrials.gov NCT04415658 . Registered on June 4, 2020.


Assuntos
Tiroxina , Obtenção de Tecidos e Órgãos , Encéfalo , Morte Encefálica , Humanos , Tiroxina/efeitos adversos , Doadores de Tecidos
9.
Anticancer Res ; 41(11): 5713-5721, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732444

RESUMO

BACKGROUND/AIM: Thyroid lobectomy may cause post-lobectomy hypothyroidism. We investigated the difference in levothyroxine (LT4) supplementation and cessation between patients with benign disease and those with papillary thyroid carcinoma (PTC) and found that the rate of LT4 cessation could be decreased after thyroid-stimulating hormone (TSH) suppression in PTC. PATIENTS AND METHODS: We retrospectively reviewed 88 patients with benign tumor and 463 patients with PTC and investigated the risk factors for LT4 supplementation after thyroid lobectomy. RESULTS: During the median follow-up of 73.0 months, 207 (37.6%) patients maintained the euthyroid state, while 344 (62.4%) patients continued LT4 supplementation for LT4 replacement or TSH suppression. In patients with benign tumors, only high pre-TSH level (>1.98 mIU/l) was a significant risk factor (odds ratio [OR]=10.09). However, in patients with PTC, pre-TSH level ≥1.98 mIU/l (OR=3.28), pregnancy planning (OR=2.97), and age ≥42.5 years (OR=1.94) were significant risk factors. Moreover, the most potent risk factor was tumor aggressiveness (OR=4.00), which was found to be more significant than high pre-TSH. The overall rate of LT4 cessation in all patients was 37.6%; however, in the 303 patients who underwent the LT4-Off trial, there was no difference in the rate in the benign tumor, low-risk PTC, and intermediate-risk PTC groups (66.2%, 68.8%, and 70.8%, respectively; p=0.886). CONCLUSION: When post-lobectomy TSH levels were adequate and the risk of recurrence was reduced, LT4 cessation in PTC could be achieved at the same rate as that in benign tumors, regardless of the duration of TSH suppression.


Assuntos
Hipotireoidismo/tratamento farmacológico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Tiroxina/administração & dosagem , Adulto , Biomarcadores/sangue , Esquema de Medicação , Feminino , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/diagnóstico , Hipotireoidismo/etiologia , Masculino , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos , Tireotropina/sangue , Tiroxina/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
10.
BMC Med ; 19(1): 266, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34727949

RESUMO

BACKGROUND: Observational studies suggest interconnections between thyroid status, metabolism, and risk of coronary artery disease (CAD), but causality remains to be proven. The present study aimed to investigate the potential causal relationship between thyroid status and cardiovascular disease and to characterize the metabolomic profile associated with thyroid status. METHODS: Multi-cohort two-sample Mendelian randomization (MR) was performed utilizing genome-wide significant variants as instruments for standardized thyrotropin (TSH) and free thyroxine (fT4) within the reference range. Associations between TSH and fT4 and metabolic profile were investigated in a two-stage manner: associations between TSH and fT4 and the full panel of 161 metabolomic markers were first assessed hypothesis-free, then directional consistency was assessed through Mendelian randomization, another metabolic profile platform, and in individuals with biochemically defined thyroid dysfunction. RESULTS: Circulating TSH was associated with 52/161 metabolomic markers, and fT4 levels were associated with 21/161 metabolomic markers among 9432 euthyroid individuals (median age varied from 23.0 to 75.4 years, 54.5% women). Positive associations between circulating TSH levels and concentrations of very low-density lipoprotein subclasses and components, triglycerides, and triglyceride content of lipoproteins were directionally consistent across the multivariable regression, MR, metabolomic platforms, and for individuals with hypo- and hyperthyroidism. Associations with fT4 levels inversely reflected those observed with TSH. Among 91,810 CAD cases and 656,091 controls of European ancestry, per 1-SD increase of genetically determined TSH concentration risk of CAD increased slightly, but not significantly, with an OR of 1.03 (95% CI 0.99-1.07; p value 0.16), whereas higher genetically determined fT4 levels were not associated with CAD risk (OR 1.00 per SD increase of fT4; 95% CI 0.96-1.04; p value 0.59). CONCLUSIONS: Lower thyroid status leads to an unfavorable lipid profile and a somewhat increased cardiovascular disease risk.


Assuntos
Doenças Cardiovasculares , Tireotropina , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Feminino , Humanos , Lipídeos , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Tiroxina , Adulto Jovem
11.
Medicina (Kaunas) ; 57(10)2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34684053

RESUMO

Here, we report a case of an increase in serum creatine kinase (CK) concentration in an 11-year-old girl being treated for Graves' disease with antithyroid drugs (ATDs). The patient complained of myalgia two weeks after methimazole treatment. Triiodothyronine (T3) and free thyroxine (FT4) levels were normal, but the serum CK level was significantly elevated. After switching to propylthiouracil, the serum CK level decreased to normal, and the myalgia was resolved. The development of myopathy during the treatment of hyperthyroidism may be considered as an adverse reaction of MMI. In this report, we present a rare pediatric case, along with a discussion on the possible causes of myopathy that occurred during the treatment of Graves' disease. A careful follow-up (serum CK levels and thyroid function) and treatment reassessment should always be considered after antithyroid treatment.


Assuntos
Doença de Graves , Tiroxina , Antitireóideos/efeitos adversos , Criança , Feminino , Doença de Graves/complicações , Doença de Graves/tratamento farmacológico , Humanos , Metimazol/efeitos adversos , Mialgia , Tri-Iodotironina
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 266-270, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645191

RESUMO

To establish reference intervals for thyroid functional indicators in early (T1), mid-term (T2), and late stage (T3) pregnancy in a population of women in Northwestern China. A cross-sectional study was conducted on 620 pregnant women. Subjects were recruited through a questionnaire where apparently healthy women were selected. Serum thyroid stimulating hormone (TSH3), total triiodothyronine (TT3), total thyroid hormone (TT4), free triiodothyronine (FT3), and free thyroid hormone (FT4) were detected using the Beckman Unicel DXI 800 automatic chemiluminescence analyzer (the third-generation TSH detection reagent for TSH3),and the reference intervals of different gestation periods were established. The results showed that the reference intervals of TSH3 in T1, T2, and T3 were 0.05-4.59, 0.61-6.01, and 0.63-4.78 mIU/L, respectively; TT3 were 1.62-2.97 nmol/L, 1.59-2.95 nmol/L, and 1.45-2.70 nmol/L, respectively; TT4 were 95.49-185.00 nmol/L, 92.70-181.54 nmol/L, and 77.93-155.09 nmol/L, respectively; FT3 were 3.18-5.22 pmol/L, 2.78-4.67 pmol/L, and 2.51-4.18 pmol/L, respectively; and FT4 were 7.72-12.97 pmol/L, 6.90-1.09 pmol/L, and 5.63-9.85 pmol/L, respectively. All thyroid function indexes had statistically significant differences between the three stages of pregnancy (TSH:H=30.879,P<0.01;FT3:H =153.827,P<0.01;FT4:H =229.967,P<0.01;TT3:H =36.484,P<0.01;TT4:H =58.531,P<0.01). 20 independent samples were collected to verify the reference intervals of TSH, FT3, FT4, TT3 and TT4 for three trimesters of pregnancy, and all of them passed.


Assuntos
Glândula Tireoide , Tiroxina , Estudos Transversais , Feminino , Humanos , Gravidez , Valores de Referência , Testes de Função Tireóidea , Tireotropina , Tri-Iodotironina
13.
Scanning ; 2021: 1834556, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630818

RESUMO

Objective: The aim of this study was to investigate the relationship between different psoriasis types and thyroid dysfunction. Methods: The data of patients diagnosed with psoriasis between January 2013 and October 2018 who underwent thyroid function tests were collected. Free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody (TGAb), and thyroid peroxidase antibody (TPOAb) were measured. The thyroid function of patients with psoriasis vulgaris, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis was evaluated, and the differences in hormone levels and antibodies in the pituitary-thyroid axis with psoriasis type were analyzed. Results: The data of a total of 468 patients were analyzed in this study. The proportion of normal hormone levels was higher among vulgaris patients (P < 0.001), while the erythrodermic patients were more likely to have decreased FT3 or FT4 but normal TSH (P < 0.001). FT3 levels were lower in pustular patients (P < 0.05), FT4 levels were lower in erythrodermic patients (P < 0.05), and TSH levels were higher in patients with psoriatic arthritis (P < 0.05). TPOAb levels were higher than normal in all patients, but there was no significant difference in the levels of TPOAb and TGAb among 4 types of the patients. Conclusion: Psoriasis is related to thyroid dysfunction, especially in patients with atypical psoriasis types. The possibility of complications should be considered in erythrodermic patients.


Assuntos
Psoríase , Glândula Tireoide , Humanos , Estudos Retrospectivos , Tireotropina , Tiroxina
14.
Front Endocrinol (Lausanne) ; 12: 746602, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34659128

RESUMO

Background: Some studies have indicated that interferon (IFN) may be valuable in COVID-19. We aimed to evaluate the impact of short-term IFN on incident thyroid dysfunction and autoimmunity among COVID-19 survivors. Methods: We included consecutive adults without known thyroid disorder admitted to Queen Mary Hospital for COVID-19 from July 2020 to January 2021 who had thyroid function tests (TFTs) and anti-thyroid antibodies measured both on admission and at three months. Results: 226 patients were included (median age 55.0 years; 49.6% men): 135 were IFN-treated. There tended to be more abnormal TFTs upon reassessment in IFN-treated patients (8.1% vs 2.2%, p=0.080). 179 patients (65.4% IFN-treated) had a complete reassessment of anti-thyroid antibodies. There were significant increases in titres of both anti-thyroid peroxidase antibodies (anti-TPO: baseline 29.21 units [IQR: 14.97 - 67.14] vs reassessment 34.30 units [IQR: 18.82 - 94.65], p<0.001) and anti-thyroglobulin antibodies (anti-Tg: baseline 8.23 units [IQR: 5.40 - 18.44] vs reassessment 9.14 units [IQR: 6.83 - 17.17], p=0.001) in the IFN-treated group but not IFN-naïve group. IFN treatment (standardised beta 0.245, p=0.001) was independently associated with changes in anti-TPO titre. Of the 143 patients negative for anti-TPO at baseline, 8 became anti-TPO positive upon reassessment (seven IFN-treated; one IFN-naïve). Incident anti-TPO positivity was more likely to be associated with abnormal TFTs upon reassessment (phi 0.188, p=0.025). Conclusion: IFN for COVID-19 was associated with modest increases in anti-thyroid antibody titres, and a trend of more incident anti-TPO positivity and abnormal TFTs during convalescence. Our findings suggest that clinicians monitor the thyroid function and anti-thyroid antibodies among IFN-treated COVID-19 survivors, and call for further follow-up studies regarding the clinical significance of these changes.


Assuntos
Autoimunidade/efeitos dos fármacos , COVID-19/tratamento farmacológico , COVID-19/imunologia , Interferon beta-1b/efeitos adversos , Interferon beta-1b/uso terapêutico , Doenças da Glândula Tireoide/induzido quimicamente , Testes de Função Tireóidea , Glândula Tireoide/efeitos dos fármacos , Adulto , Anticorpos/análise , Estudos de Coortes , Feminino , Seguimentos , Humanos , Imunoglobulinas Glândula Tireoide-Estimulantes/análise , Masculino , Pessoa de Meia-Idade , Sobreviventes , Doenças da Glândula Tireoide/imunologia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
15.
Environ Toxicol Pharmacol ; 88: 103759, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34695539

RESUMO

Electronic cigarettes (e-cigarettes) have been marketed as a less lethal substitute for smoking traditional cigarettes. This study aims to investigate the impact of e-cigarettes aerosol exposure on lactating dams and pups, whose dams were exposed. Lactating dams received fresh air (control) or e-cigarettes aerosol during lactation (day 4-21). Maternal exposure to e-cigarettes aerosol during lactation induced significant reduction (P < 0.0001) in the fat content of the milk and serum Leptin level (P < 0.005) compared to control dams. Furthermore, pups whose dams were exposed to e-cigarettes during lactation showed an increased level of glucose, thyroxine and decreased level of insulin. The exposure to e-cigarettes aerosol during lactation altered the composition of milk as well as the hormonal and biochemical profile in dams and pups. This result, if observed in women using e-cigarettes, suggests that e-cigarettes' use during lactation may have consequences on the milk production and hormonal and biochemical profile in breastfeeding mothers and nursing babies.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Lactação , Exposição Materna/efeitos adversos , Administração por Inalação , Aerossóis , Animais , Glicemia/análise , Gorduras/análise , Feminino , Insulina/sangue , Lactação/sangue , Leptina/sangue , Masculino , Leite/química , Ratos Wistar , Tiroxina/sangue
16.
Med Clin North Am ; 105(6): 1033-1045, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34688413

RESUMO

Subclinical thyroid disease is frequently encountered in clinic practice. Although overt thyroid dysfunction has been associated with adverse clinical outcomes, uncertainty remains about the implications of subclinical thyroid disease. Available data suggest that subclinical hypothyroidism may be associated with increased risk of cardiovascular disease and death. Despite this finding, treatment with thyroid hormone has not been consistently demonstrated to reduce cardiovascular risk. Subclinical hyperthyroidism has been associated with increased risk of atrial fibrillation and osteoporosis, but the association with cardiovascular disease and death is uncertain. The decision to treat depends on the degree of thyroid-stimulating hormone suppression and underlying comorbidities.


Assuntos
Tomada de Decisão Clínica , Doenças da Glândula Tireoide/epidemiologia , Fatores Etários , Fibrilação Atrial/epidemiologia , Doenças Cardiovasculares/epidemiologia , Transtornos Cognitivos/epidemiologia , Comorbidade , Humanos , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Osteoporose/epidemiologia , Fatores de Risco , Doenças da Glândula Tireoide/sangue , Tireotropina/sangue , Tiroxina/sangue
17.
J Exp Biol ; 224(20)2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34605889

RESUMO

Maternal hormones constitute a key signalling pathway for mothers to shape offspring phenotype and fitness. Thyroid hormones (THs; triiodothyronine, T3; and thyroxine, T4) are metabolic hormones known to play crucial roles in embryonic development and survival in all vertebrates. During early developmental stages, embryos exclusively rely on exposure to maternal THs, and maternal hypothyroidism can cause severe embryonic maldevelopment. The TH molecule includes iodine, an element that cannot be synthesised by the organism. Therefore, TH production may become costly when environmental iodine availability is low. This may yield a trade-off for breeding females between allocating the hormones to self or to their eggs, potentially to the extent that it even influences the number of laid eggs. In this study, we investigated whether low dietary iodine may limit TH production and transfer to the eggs in a captive population of rock pigeons (Columba livia). We provided breeding females with an iodine-restricted (I-) diet or iodine-supplemented (I+) diet and measured the resulting circulating and yolk iodine and TH concentrations and the number of eggs laid. Our iodine-restricted diet successfully decreased both circulating and yolk iodine concentrations compared with the supplemented diet, but not circulating or yolk THs. This indicates that mothers may not be able to independently regulate hormone exposure for self and their embryos. However, egg production was clearly reduced in the I- group, with fewer females laying eggs. This result shows that restricted availability of iodine does induce a cost in terms of egg production. Whether females reduced egg production to preserve THs for themselves or to prevent embryos from exposure to low iodine and/or THs is as yet unclear.


Assuntos
Columbidae , Iodo , Animais , Gema de Ovo , Feminino , Hormônios Tireóideos , Tiroxina , Tri-Iodotironina
18.
BMJ Case Rep ; 14(10)2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34649855

RESUMO

A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient's own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible.


Assuntos
Hipertireoidismo , Transtornos Psicóticos , Comportamento Autodestrutivo , Neoplasias da Glândula Tireoide , Feminino , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/tratamento farmacológico , Radioisótopos do Iodo , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/etiologia , Comportamento Autodestrutivo/complicações , Tiroxina/uso terapêutico
19.
Anal Chem ; 93(44): 14869-14877, 2021 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-34714056

RESUMO

Thyroid hormones are biologically active small molecules responsible for growth and development regulation, basal metabolic rate, and lipid and carbohydrate metabolism. Liquid chromatography mass spectrometry (LC-MS) can be used to quantify thyroid hormones blood level with high speed and selectivity, aiming to improve the diagnosis and treatment of the severe pathological conditions in which they are implicated, i.e., hypo- and hyperthyroidism. In this work, the gas-phase behavior of the isomeric thyroid hormones triiodothyronine (T3) and reverse triiodothyronine (rT3) in their deprotonated form was studied at a molecular level using MS-based techniques. Previously reported collision-induced dissociation experiments yielded distinct spectra despite the high structural similarity of the two compounds, suggesting different charge sites to be responsible. Infrared multiple photon dissociation spectroscopy on [T3-H]- and [rT3-H]- was performed, and the results were interpreted using DFT and MP2 calculations, assessing the prevalence of T3 in the carboxylate form and rT3 as a phenolate isomer. The different deprotonation sites of the two isomers were also found to drive their ion-mobility behavior. In fact, [T3-H]- and [rT3-H]- were successfully separated. Drift times were correlated with collisional cross section values of 209 and 215 Å2 for [T3-H]- and [rT3-H]-, respectively. Calculations suggested the charge site to be the main parameter involved in the different mobilities of the two anions. Finally, bare [T3-H]- and [rT3-H]- were made to react with neutral acetylacetone and trifluoroacetic acid, confirming rT3 to be more acidic than T3 in agreement with the calculated gas-phase acidities of T3 and rT3 equal to 1345 and 1326 kJ mol-1, respectively.


Assuntos
Tri-Iodotironina Reversa , Tri-Iodotironina , Cromatografia Líquida , Hormônios Tireóideos , Tiroxina
20.
J Coll Physicians Surg Pak ; 31(9): 1099-1101, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34500529

RESUMO

The levothyroxine absorption test for the assessment of pseudo-malabsorption in patients with refractory hypothyroidism has not been standardised. The aim of this observational study was to describe a protocol for levothyroxine (LT-4) absorption test in patients with refractory hypothyroidism, to report possible side effects and to emphasise the importance of pseudo-malabsorption in the differential diagnosis. The results of 10 patients, who underwent LT-4 absorption tests because thyroid stimulating hormone suppression could not be achieved despite the need for LT-4 >3 mcg/kg/day, were retrospectively analysed. When compared with basal free T4 (fT4), a statistically significant increase in fT4 was observed after the first hour (p=0.012). fT4 reached its peak level and plateau at the 4th hour. The fT4 peak level increased 3.25 times compared to baseline. The shorter LT-4 absorption test with low doses may provide an alternative method to the commonly used longer protocols with higher doses to rule out malabsorption. Key Words: Levothyroxine absorption test, Pseudo-malabsorption, Resistant hypothyroidism.


Assuntos
Hipotireoidismo , Tiroxina , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/tratamento farmacológico , Estudos Observacionais como Assunto , Estudos Retrospectivos , Testes de Função Tireóidea , Tireotropina
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